Two New York Times's liberal columnists are agreed: Repealing Obama-care would have a massive body count. Paul Krugman (pictured) wished readers a happy Monday with his cheerfully titled column "Death by Ideology."
Mitt Romney doesn’t see dead people. But that’s only because he doesn’t want to see them; if he did, he’d have to acknowledge the ugly reality of what will happen if he and Paul Ryan get their way on health care.
Last week, speaking to The Columbus Dispatch, Mr. Romney declared that nobody in America dies because he or she is uninsured: “We don’t have people that become ill, who die in their apartment because they don’t have insurance.” This followed on an earlier remark by Mr. Romney -- echoing an infamous statement by none other than George W. Bush -- in which he insisted that emergency rooms provide essential health care to the uninsured.
These are remarkable statements. They clearly demonstrate that Mr. Romney has no idea what life (and death) are like for those less fortunate than himself.
So the reality, to which Mr. Romney is somehow blind, is that many people in America really do die every year because they don’t have health insurance.
How many deaths are we talking about? That’s not an easy question to answer, and conservatives love to cite the handful of studies that fail to find clear evidence that insurance saves lives. The overwhelming evidence, however, is that insurance is indeed a lifesaver, and lack of insurance a killer. For example, states that expand their Medicaid coverage, and hence provide health insurance to more people, consistently show a significant drop in mortality compared with neighboring states that don’t expand coverage.
So there’s no real question that lack of insurance is responsible for thousands, and probably tens of thousands, of excess deaths of Americans each year....
The previous day the Times had plastered a similar piece, columnist Nicholas Kristof's "A Possibly Fatal Mistake," across the front of the Sunday Review. The text box: "An old college friend is fighting for his life. His story underscores why this election matters." Its a full-on sentimental plea for Obama-care and a vote for Obama, complete with a heart-rending photo of the old college roommate, Scott Androes in the hospital with cancer.
Yet for all his innate prudence, Scott now, at age 52, is suffering from Stage 4 prostate cancer, in part because he didn’t have health insurance. President Obama’s health care reform came just a bit too late to help Scott, but it will protect others like him -- unless Mitt Romney repeals it.
If you favor gutting “Obamacare,” please listen to Scott’s story. He is willing to recount his embarrassing tale in part so that readers can learn from it.
Yet Androes himself admitted he messed up mightily, quitting his job without securing health insurance and refusing to pay out of pocket to see a doctor even after he found blood in his urine, betting on his cancerous symptoms "being an infection." Andreos ended up being diagnosed with Stage 4 prostate cancer.
Kristof took up the discussion:
Let’s just stipulate up front that Scott blew it. Other people are sometimes too poor to buy health insurance or unschooled about the risks. Scott had no excuse. He could have afforded insurance, and while working in the pension industry he became expert on actuarial statistics; he knew precisely what risks he was taking. He’s the first to admit that he screwed up catastrophically and may die as a result.
Yet remember also that while Scott was foolish, mostly he was unlucky. He is a bachelor, so he didn’t have a spouse whose insurance he could fall back on in his midlife crisis. In any case, we all take risks, and usually we get away with them. Scott is a usually prudent guy who took a chance, and then everything went wrong.
The Mitt Romney philosophy, as I understand it, is that this is a tragic but necessary byproduct of requiring Americans to take personal responsibility for their lives. They need to understand that mistakes have consequences. That’s why Romney would repeal Obamacare and leave people like Scott to pay the price for their irresponsibility.
To me, that seems ineffably harsh. We all make mistakes, and a humane government tries to compensate for our misjudgments. That’s why highways have guardrails, why drivers must wear seat belts, why police officers pull over speeders, why we have fire codes. In other modern countries, Scott would have been insured, and his cancer would have been much more likely to be detected in time for effective treatment.
Is that a nanny state? No, it’s a civilized one.
Reason magazine's Nick Gillespie responded to Kristof on Monday, disputing whether Obama-care would have made any difference to Mr. Androes.
So maybe if he'd been forced to buy insurance against his will, he would have also visited the doctor for annual physicals including prostate exams or at least blood screens for that sort of trouble. Maybe, though having insurance and using it for the sorts of regular care (such as blood screens for PSA levels) that would have caught this problem early on are very different matters. Although Kristof quotes studies that conclude close to 30,000 people a year die prematurely due to a lack of health insurance, the link between having health insurance and having improved health is far from clear ...having insurance is hardly the be-all and end-all that many supporters of a universal mandate presume. That's even more the case when you factor in the likely outcome that an increase in the number of patients without a corresponding increase in the number of providers will hardly make it easier for people to schedule routine examinations.